Michalik Tomasz, Matkowski Rafal, Biecek Przemyslaw, Szynglarewicz Bartlomiej
Breast Unit, Lower Silesian Oncology Center - Regional Comprehensive Cancer Center, Plac Hirszfelda 12, 53-413 Wroclaw, Poland.
Department of Oncology, Faculty of Postgraduate Medical Training, Wroclaw Medical University, Plac Hirszfelda 12, 53-413 Wroclaw, Poland.
J Cancer. 2019 Jun 9;10(15):3481-3485. doi: 10.7150/jca.29774. eCollection 2019.
: Seroma formation (SF) is the most common postoperative complication after mastectomy and axillary surgery. The aim of this study was to assess its incidence and risk factors following a modified radical mastectomy in breast cancer patients. : 271 patients who underwent a modified radical mastectomy (250 with traditional electrocautery and 21 with an ultrasonic scalpel) were studied. The SF rate was calculated and its association with patient-related factors, surgical features and postoperative variables was assessed and statistically analyzed with <0.05 as a significance threshold. : SF was observed in 18% of patients. Patient's age, operating time and number of removed axillary lymph nodes did not significantly differ between SF and non-SF patients. Patients BMI, total drainage amount, number of days with drain were higher and postoperative hospital stay was significantly longer in SF patients (<0.001 each). The dissection instrument was also an important risk factor: SF developed in 20% of patients operated with electrocautery and in none with an ultrasonic scalpel (<0.05). The association between surgical instrument and the number of removed lymph nodes, patient's age and BMI was not significant. Dissection with an ultrasonic scalpel resulted in a statistically significant lower total drainage amount. However, it was also related to a significantly longer operating time (<0.001 each). : Risk of SF after a modified radical mastectomy is significantly higher in patients with obesity. Despite longer operating time, using an ultrasonic scalpel is a valuable option in those cases because it lowers the total drainage amount and seems to be an important protective factor against SF.
血清肿形成（SF）是乳房切除术和腋窝手术后最常见的术后并发症。本研究的目的是评估乳腺癌患者改良根治性乳房切除术后血清肿的发生率及危险因素。对271例行改良根治性乳房切除术的患者（250例采用传统电灼术，21例采用超声刀）进行了研究。计算血清肿发生率，并评估其与患者相关因素、手术特征及术后变量的关联，并以<0.05作为显著性阈值进行统计学分析。18%的患者出现血清肿。血清肿患者与非血清肿患者在年龄、手术时间及腋窝淋巴结清扫数量方面无显著差异。血清肿患者的体重指数（BMI）、总引流量、置管天数更高，术后住院时间显著更长（均P<0.001）。手术器械也是一个重要的危险因素：采用电灼术的患者中20%发生血清肿，而采用超声刀的患者均未发生血清肿（P<0.05）。手术器械与清扫淋巴结数量、患者年龄及BMI之间的关联不显著。使用超声刀进行手术导致总引流量在统计学上显著降低。然而，这也与手术时间显著延长有关（均P<0.001）。改良根治性乳房切除术后，肥胖患者发生血清肿的风险显著更高。尽管手术时间更长，但在这些病例中使用超声刀是一种有价值的选择，因为它可降低总引流量，似乎是预防血清肿的一个重要保护因素。
